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MoD to continue issuing controversial anti-malarial drug despite MPs' criticism

Published 24/05/2016

The Ministry of Defence has been criticised by MPs over the way the controversial anti-malarial drug, Lariam, has been issued to troops on overseas operations.
The Ministry of Defence has been criticised by MPs over the way the controversial anti-malarial drug, Lariam, has been issued to troops on overseas operations.

The Ministry of Defence is to continue issuing a controversial anti-malarial drug to some troops on overseas operations, despite strong criticism from MPs over the way it has been prescribed.

The Commons Defence Committee said there was "strong anecdotal evidence" that stringent conditions laid down by the manufacturers for issuing Lariam had been ignored by the armed forces.

It called for the drug - which has been associated in a minority of users with depression, hallucinations and panic attacks - to be designated a "drug of last resort", only to be issued when there was no alternative available.

The Surgeon General of the armed forces, Vice Admiral Alasdair Walker, said it was important to retain Lariam for personnel who were unable to take other anti-malarial drugs.

"We would not want to take that drug out of our armamentarium," he told the BBC Radio 4 Today programme.

"Under very close control with very careful assessments, then Lariam still is an effective drug, but it has to have that careful assessment. It is not our frontline drug. It is only for people who are unable to take the other drugs."

While Lariam is not the main anti-malarial drug used by the armed forces, at least 17,368 personnel were prescribed it at least once between the start of April 2007 and the end of March 2015, according to official MoD figures.

The committee said it had received strong anecdotal evidence that a body of current and former service personnel had been adversely affected by its use and that the arrangements for supporting them were "inadequate".

While the manufacturer, Roche, had issued "clear guidance" that individual risk assessments should be conducted before prescribing, the committee said the MoD appeared to have interpreted this to include "desk-based" assessments using medical records rather than face-to-face interviews.

It said it was "deeply disturbing" that some personnel apparently preferred to throw away the Lariam they had been prescribed and run the risk of contracting malaria, rather than take the drug.

"If true, it is an indication that some in the armed forces have completely lost confidence in Lariam," the committee said.

"Lariam is a drug whose own manufacturers have laid down stringent conditions which must be met if it is to be prescribed safely.

"We see no reason to disbelieve the very strong anecdotal evidence that such conditions have been ignored in dispensing it to large numbers of troops about to be deployed."

The committee chairman Julian Lewis said: "It is our firm conclusion that there is neither the need, nor any justification, for continuing to issue this medication to service personnel unless they can be individually assessed, in accordance with the manufacturer's requirements.

"And - most of the time - that is simply impossible, when a sudden, mass deployment of hundreds of troops is necessary."

An MoD spokesman said: "The vast majority of deployed personnel already receive alternatives to Lariam and, where it is used, we require it to be prescribed after an individual risk assessment.

"We have a duty to protect our personnel from malaria and we welcome the committee's conclusion that, in some cases, Lariam will be the most effective way of doing that."

Kevin Timms, a lawyer for armed forces personnel who suffered side-effects from Lariam, said: "The announcement that Lariam is finally to be banned for military use apart from in exceptional circumstances is to be welcomed but this action comes too late for the many veterans who have already suffered from its serious side-effects. We have heard first-hand how it has ruined lives.

"It is now imperative that the new guidelines for prescribing Lariam are implemented as soon as possible and that the MoD clarifies the support it will be offering to armed forces personnel affected.

"It is vital that this includes the provision of adequate resources to ensure Lariam side- effects are properly diagnosed and urgently treated. Only then will our service personnel receive the help they require."

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